Peace Lutheran Church

Evangelical Lutheran Church in America
(320) 685-7656

SuperStars Registration


Please complete/submit the information below for each child you would like to attend SuperStars. When you have finished; click on the Add to Cart button below to make your payment.

Payments are securely processed through PayPal; a PayPal account is not required to complete the transaction.


Name
Birthdate
Gender
Grade (2015-16)
Allergies/Health Concerns
Preferred E-mail Address
Alternate E-mail Address
Preferred Phone #
Phone Type
Alternate Phone #
Phone Type
Parent/Guardian Name
Parent/Guardian Birthdate
Parent/Guardian Workplace
Parent/Guardian Occupation
Alternate Parent/Guardian Name
Alternate Parent/Guardian Birthdate
Alternate Parent/Guardian Workplace
Alternate Parent/Guardian Occupation
Home Address (Street)
City/ST/Zip
Alternate Home Address (Street)
City/ST/Zip
Emergency Contact
Relationship
Emergency Contact #
I authorize my child(ren) to be photographed during church-sponsored events and activities, to be used for marketing and communication purposes only.yes
no
I authorize my child(ren) to attend church-sponsored field trips and service projects and be given transportation to and from, if provided. (Prior notification is given for ALL off-site activities.)yes
no
Please enter the letters that appear in this image
By clicking this box, I agree to enroll my child in the Children's Ministry Program. I give permission for my child's personal information to be accessible to church staff and volunteers.yes
no

2014 Registration $20